Bondarenko A V, Karavaev B I, Tugarinov S A
Anesteziol Reanimatol. 1994 May-Jun(3):6-8.
Thirty-four patients in the early postoperative period after surgery on the lungs and mediastinum and 23 patients after cardiopulmonary bypass surgery have been examined. 187 studies of central hemodynamics and pulmonary function during cardiopulmonary bypass have been performed to investigate the correlation between pulmonary hemodynamics and parameters of respiratory mechanics in the early postoperative period after thoracic surgery. The studies have revealed reverse dependence of lung and chest compliance (C) on pulmonary artery diastolic pressure (PAPdiast) (r = -0.61, p < 0.05) in patients after thoracic surgery with clinical signs of cardiopulmonary failure. When analogous studies were performed in patients with intact lungs after aortocoronary bypass, C/PAPdiast correlation was more close (r = 0.880, p < 0.05). At the same time there is a correlation between C and extracellular fluid volume (r = -0.7). The above correlations to a great extent predetermine the pathogenesis of respiratory failure in the postoperative period.
对34例肺和纵隔手术后处于术后早期的患者以及23例体外循环手术后的患者进行了检查。为研究胸科手术后早期肺血流动力学与呼吸力学参数之间的相关性,共进行了187项体外循环期间中心血流动力学和肺功能的研究。研究发现,有心肺功能衰竭临床体征的胸科手术患者,肺和胸廓顺应性(C)与肺动脉舒张压(PAPdiast)呈负相关(r = -0.61,p < 0.05)。在主动脉冠状动脉搭桥术后肺功能正常的患者中进行类似研究时,C/PAPdiast的相关性更强(r = 0.880,p < 0.05)。同时,C与细胞外液量之间存在相关性(r = -0.7)。上述相关性在很大程度上决定了术后呼吸衰竭的发病机制。